1. Field of the Invention
The present invention pertains to a method and a device for the treatment of anxiety disorders including panic attacks.
2. Description of Related Prior Art
Anxiety disorders are common psychiatric illnesses associated with considerable morbidity and social cost. Panic attack is one form of anxiety disorders. The criteria for panic attack diagnosis is in DSM-IV (Diagnostic and Statistical Manual of Mental Disorders ed. 4). One published epidemiological study using DSM-III-R panic disorder criteria found a lifetime prevalence of 3.5 percent. Of course many sufferers are undiagnosed, misdiagnosed, or untreated. Patients with panic attack suffer severely by the sudden onset of fear of dying, fear of insanity, palpitations, shortness of breath, chest pain, sweating, choking, and dizziness.
In Western medicine, there have been three main approaches to the treatment of anxiety disorders—pharmacotherapy (medications), non-medication therapies such as cognitive-behavioral therapy (discussion, relaxation, other psychological methods) and combinations of the two approaches. All three approaches have been helpful to some degree in many patients but have not been entirely satisfactory.
For pharmacotherapy treatment, it is important that the patient be aware of drug side effects and possible interactions with other medications. Effective types of medication include tricyclic antidepressants, monoamine oxidase inhibitors, benzodiazepines, and serotonergic agents.
Imipramine, a tricyclic antidepressant, has been shown to be helpful in double blind studies. The acute effect of imipramine is to block the re-uptake of the neurotransmitters, norepinephrine and serotonin, from the synaptic cleft into the presynaptic neuron. Many patients are sensitive to impipramine (side effects), but high doses are necessary to be helpful. Other tricyclics, such as desipramine (Norpramine), amitryptaline (Elavil), doxapin (Adapin), nortryptaline (Pamdor), and chloripramine (Anatranil) may also be effective dicyclics, but not well tolerated by all patients and are dangerous if overdosed.
Monoamine oxidase inhibitors, for example phenelzine (Nordil), are also somewhat effective antipanic agents by inhibiting the extraneuronal enzyme, monoamine oxidase, from metabolizing monoamines. Three to six weeks of drug administration are necessary before the drug becomes effective. The main drawback is the tendency of these drugs to develop the tyramine effect, allowing tyramine to enter the blood and provoke a hypertensive crisis.
Special diazepams, such as alprozalam (Xanax) and clorazepam (Klonopin), are somewhat effective against panic attack. It is believed that these drugs attach to benzodiazepine receptors in the brain, thus inhibiting neurons by inhibiting chloride ionophores. Conventional diazepams such as Valium are not reliable for blocking panic attacks.
Still another class of antipanic medications is seratonin-specific reuptake inhibitors (SSRIs) such as paroxetine (PAXIL) and sertaline (ZOLOFT). This group of drugs is characterized by its ability to selectively inhibit the reuptake of seratonin. Although SSRIs are effective in open trials, controlled studies have not yet been published. SSRIs can also cause gastrointestinal distress, hypomania, headaches, sexual dysfunction, and insomnia.
Non-medication approaches include (1) cognitive therapy and psycho educations, (2) applied relaxation, (3) respiratory control, and (4) exposure therapy. Cognitive therapy techniques include convincing the patient that the panic attack is short-lived and not very serious. Applied relaxation includes progressive muscle relaxation and thought control. Respiratory control techniques are to prevent hyperventilation. Exposure therapy means confrontation of the patient with the panic stimulus. Sometimes the combination of pharmacotherapy and cognitive therapy provides effective results.
All the above treatments have some merit, but they tend to have a slow and incomplete effect. In addition, the treatments can be expensive and the medications can be somewhat toxic. It is desirable to have a simple, effective, nontoxic, safe, inexpensive, time-saving, and convenient treatment for panic disorders.